Mechanisms Leading to Sedentary Behaviors among Older Adults in Chinese Residential Care Homes: The Capability, Opportunity, Motivation-Behavior Model Guided Structural Equation Modeling

Abstract

Objective: To evaluate sedentary behaviors among older adults in residential care homes and explore potential mechanisms leading to sedentary behaviors based on the Capability, Opportunity, and Motivation to Behavior (COM-B) model.

Design: Cross-sectional study.

Setting and participants: We collected data from 329 residents who lived in 11 residential care homes in China.

Method: We collected self-reported survey data on resident demographics, sedentary behavior, activities of daily living (ADLs), social support, exercise self-efficacy, and depressive symptoms. Mean and standard deviation were used to describe the sedentary behavior of older adults in care homes. We drew on the COM-B model and constructed a structural equation model to assess the interrelationships of ADLs, social support, exercise self-efficacy, depressive symptoms, and sedentary behavior.

Result: The average daily sedentary time of older adults in our sample was 11.4 hours (SD = 2.6). Social support not only directly influenced sedentary behavior of older adults in care homes (β = 0.042; P = .039; 95% CI, -0.054 to -0.031]), but also indirectly through exercise self-efficacy (β = 0.003; P < .001; 95% CI, -0.023 to -0.011]) and depressive symptoms (β = 0.003; P < .001; 95% CI, -0.018 to -0.006) affected sedentary behaviors. ADLs indirectly affected sedentary behaviors through exercise self-efficacy (β = 0.029; P < .001; 95% CI, -0.220 to -0.107) and depressive symptoms (β = 0.099; P < .001; 95% CI, -0.161 to -0.053).

Conclusions and implications: The high levels of sedentary behaviors among our sample of residents warrant awareness among long-term care staff and managers. Potential strategies for reducing sedentary behaviors include promoting social support, enhancing exercise self-efficacy, and managing depressive symptoms.

Keywords: Sedentary behavior; older people; residential care home; structural equation modeling.